Inflammatory bowel disease (IBD) is a disorder of unknown aetiology characterised typically by diarrhoea, cramping, abdominal pains, weight loss and rectal bleeding. It encompasses such disorders as Crohn's disease, ulcerative colitis, indeterminate colitis, microscopic colitis and collagenous colitis. Its cause is unknown. However, in the past there has been some evidence that Mycobacterium paratuberculosis (Mp) and perhaps its various sub-strains, may play an infective role by entering the cells which make up the bowel wall. The source of this bacterium is unclear but may reside in other animals such as sheep, cattle, rabbits, as well as other humans. It may be transmitted to people perhaps via milk, contaminated water supplies, poorly cooked meat, etc. Although there has been long-standing controversy about the involvement of Mp in causation of Crohn's disease, recent applications of PCR usage are beginning to confirm that most Crohn's cases are indeed infected with this organism which is likely to be the causal infective agent. In the past, therapy directed at the eradication of Mp by using combined anti-TB drugs eg INH, pyrazinamide, streptomycin, ethambutol, rifampicin and PAS have been generally of little help to patients. In other words, although transient improvements in a proportion of patients did occur, no patient was cured. In fact, even if Mp had been the cause of this disease there was no effective therapy available for Mp since it was an "atypical mycobacterium" and for atypical mycobacteria there was no known therapy. Furthermore, since Mycobacterium paratuberculosis has a long division time multiple antimicrobial drugs are required to the treat the infection which has to be carried out for a long period of time--akin to the treatment used in the therapy of Mycobacterium tuberculosis. Furthermore, Mycobacterium tuberculosis therapy with the current drugs results in resistant strains forming. Such resistant strains do not become eradicated with known antimicrobial agents. Hence, there is no known effective cure for resistant TB.
Accordingly, there is a need for an effective treatment of inflammatory bowel disease, and in particular Crohn's disease. It is an object of this invention to provide such a treatment.
Surprisingly, the present inventor has discovered that the metabolism of the mycobacteria believed to be responsible for the symptoms of inflammatory bowel disorders may be inhibited long enough to cure the infection and thus relieve the symptoms, by administering to the patient a combination of anti-atypical mycobacterial agents and/or an immunising amount of a mycobacterial product.